Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Acta Neurol Scand. 2022 Dec;146(6):767-774. doi: 10.1111/ane.13699. Epub 2022 Sep 7.
Sleep disorder is common in epilepsy. With a recent rapid development in sleep medicine, it has been increasingly recognized that anti-seizure therapies, either anti-seizure medications (ASMs) or non-pharmaceutical approaches, can take direct or indirect influence on sleep in patients with epilepsy. Here, we systematically review the effect of anti-seizure treatments on sleep. ASMs targeting at different sites exerted various effects on both sleep structure and sleep quality. Non-pharmaceutical treatments including resective surgery, ketogenic diet, and transcranial magnetic stimulation appear to have a positive effect on sleep, while vagus nerve stimulation, deep brain stimulation, and brain-responsive neurostimulation are likely to interrupt sleep and exacerbate sleep-disordered breathing. The potential mechanisms underlying how non-pharmacological approaches affect sleep are also discussed. The limitation of most studies is that they were largely based on small cohorts by short-term observations. Further well-designed and large-scale investigations in this field are warranted. Understanding the effect of anti-seizure therapies on sleep can guide clinicians to optimize epilepsy treatment in the future.
睡眠障碍在癫痫中很常见。随着睡眠医学的迅速发展，人们越来越认识到抗癫痫治疗（无论是抗癫痫药物还是非药物方法）都可能直接或间接影响癫痫患者的睡眠。在这里，我们系统地回顾了抗癫痫治疗对睡眠的影响。针对不同部位的抗癫痫药物对睡眠结构和睡眠质量都有不同的影响。包括切除手术、生酮饮食和经颅磁刺激在内的非药物治疗似乎对睡眠有积极影响，而迷走神经刺激、深部脑刺激和脑反应性神经刺激可能会中断睡眠并加重睡眠呼吸障碍。此外，还讨论了非药物治疗方法影响睡眠的潜在机制。大多数研究的局限性在于它们主要基于短期观察的小队列。该领域需要进一步进行设计良好和大规模的调查。了解抗癫痫治疗对睡眠的影响可以指导临床医生在未来优化癫痫治疗。
